Individual provider Active NPI

Kimberly Grimsley Christen, PHARM.D.

  • Pharmacist
  • Hattiesburg, MS
National Provider Identifier
1215414776
Registry record updated Jul 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
E0-9971 Issued in MS
Practice address
6051 U S Highway 49
Hattiesburg, MS 39401-7200
Phone
(601) 288-5128
NPI assigned
Jul 26, 2018
Last updated
Jul 26, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X E0-9971 MS Primary

Addresses

Primary practice location

6051 U S Highway 49
Hattiesburg, MS 39401-7200

Mailing address

811 Leeville Rd
Petal, MS 39465-9499

Other names 1

  • Kimberly Ann Grimsley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
E0-9971MSMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1532563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532563200000",
    "number": "1215414776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 LEEVILLE RD",
            "city": "PETAL",
            "state": "MS",
            "postal_code": "394659499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6051 U S HIGHWAY 49",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017200",
            "telephone_number": "601-288-5128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTEN",
        "first_name": "KIMBERLY",
        "middle_name": "GRIMSLEY",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-26",
        "last_updated": "2018-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "E0-9971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "GRIMSLEY",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hattiesburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.